I mentioned a couple of weeks ago that I was in travel mode for a few straight weeks of continuing education courses. This past week I was in Detroit, which I will discuss below. This coming weekend I was scheduled to travel to northern New Jersey. Well, Hurricane Sandy postponed those plans. My heart goes out to those affected by her devastation and I wish them the best as they try to pick up the pieces and return to normalcy.
This week I would like to discuss two other areas of devastation that I encountered on my most recent trip to Detroit. The course itself was a live-patient course utilizing a unique type of surgical extraction instruments. Although I was very impressed with the course and instruments, there is nothing really more to report that would interest the readers of this column. The two areas of devastation I encountered, however, are worth mentioning.
I saw numerous patients in Detroit who presented with the need for treatment that they could not otherwise afford. Two of the patients I treated needed full-mouth extractions. One was an older gentleman who had recently finished radiation treatment for cancer and the other was a 21-year-old man who has been using methamphetamine (crystal meth). The effects of both of their situations led to the demise of their teeth.
Meth is highly addictive; many users are hooked the first time they try it. Long-term abuse can cause serious dental deterioration, hallucinations, heart failure, brain damage, and stroke, not to mention devastating the lives of addicts and their families.
People think that all drug users look strange, but the reality is that some are normal, good-looking kids, high-school students, even parents. Although my patient did not report any use of drugs, it was apparent from the distinct look of his teeth that he was a heavy meth user.
The signs of possible meth use are many. In addition to physical and behavioral changes, one of the earliest symptoms is gum-line decay of the teeth, caused by both the chemicals in the drug and reduced hygiene (tooth brushing). In more advanced cases, the teeth take on a grayish-brown appearance, then become weak — cracking and breaking easily — and eventually spongy. After long-term decay, teeth take on a goblet shape and the term “meth mouth” is used to describe them. This describes my patient’s teeth exactly. Devastating.
Radiation treatment can have a similar effect on the teeth. It can have both an effect on the teeth themselves and the bone that supports them. My patient had quite a bit of good restorative dentistry performed on him in his younger years but had not seen a dentist for approximately 10 years.
When he was diagnosed with cancer, he underwent radiation treatment without working directly with a dentist. The treatment caused severe dry mouth (xerostomia) which led to rampant decay around the necks of all of his teeth. In addition, the radiation also made his bone extremely brittle, which further complicated the procedure I was doing. Patients who need to undergo radiation treatment should work directly with a dentist and consider intense fluoride treatments and any teeth that need to be extracted should be done prior to radiation treatment.
It is always saddening to see devastation. And, although there is gratification in helping those in need, we should be mindful of the steps we can take in our own individual situations to avoid the unnecessary.